Joint Commission Accreditation

Michael Kulczycki, MBA, is executive director of the Ambulatory Care Accreditation program of the Joint Commission. In the second of a three-part series, Kulczycki offers general information about the program.

Prior to 2004, the common perception, and it was somewhat accurate, was that the Joint Commission’s process was a paper-and-policy-based process, that most of the survey time was spent with surveyors in a conference room with a limited number of people they were talking to, and having extensive piles of policies and binders that they were receiving. That was all thrown out the window with our new process that started in 2004.

The agenda now includes about 60 percent of the total time—and for the typical urgent care center it would be a single surveyor for two days—focused on accomplishing the “Patient Tracer.”

Over the course of two days the survey is going to pull two to three patient charts and use that as a roadmap through the organization.

They pull that based on data they have going into the survey on the volume of patients and the kind of services the patient received. In an urgent care environment, they would probably make sure one of the patient’s records they’re pulling is a patient who got some diagnostic imaging done.

They’re likely to pull a record of a laceration repair, or when a patient was transferred to another facility based on the seriousness of the injury. They pull three to four charts—they don’t literally follow the patient physically through the center.

They start by talking to the person at the front desk who admitted the patient and took their information, to any of the caregivers who may have been in contact with that patient, whether it’s the technician doing the imaging read, the caregiver, the physician, etc.

They’re very sensitive about not interrupting the patient flow. They realize that urgent care centers are a high-volume operation and they work around the patients that need to be seen. ...They’re trying to use the dialogue process as well as what they observed while they’re doing these tracers as a way to evaluate that center against all the standards that are applicable. They may be talking to two to five staff people with each tracer that they pull.

To view a six-minute video about the patient-tracer process, visit the resources section of www.immediatecarebusiness.com. icb

For the last installment of Kulczycki’s Q&A, read the July/August issue of Immediate Care Business.

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